The Experience to Use a Modified En Bloc Excision Technique in Vitrectomy for Diabetic Traction Retinal Detachment

以附加Modified En Bloc Excision技巧之玻璃體切除術治療糖尿病牽引性視網膜剝離之研究

吳文權(Wen-Chuan Wu) ； 林至謙(Jyh-Chain Lin)

《The Kaohsiung Journal of Medical Sciences》 15卷8期 (1999/08) Pp. 461-467

https://doi.org/10.6452/KJMS.199908.0461

摘要

以傳統之玻璃體切除術來治療糖尿病牽引性視網膜剝離常會造成網膜裂孔如不易控制之血而減少成功率。Modified en bloc excision是一種手術技巧，它保留纖維膜切除區上方之posterior hyaloid membrane，病例用雙手操作之原則剝除纖維血管膜且與殘存之hyaloid membrane一併切除。本篇報告以此種方法治療16例糖尿病牽引性視網膜剝離之病患。經過至少6個月以上之追蹤，最佳矯正視力達5/200以上者占11例（69％）。總計視力改善者店12例（75％）而黃斑部附近視網膜完全貼回者占14例（87％）。我們認為此種手術技巧能增加手術之成功率並減少術後之後遺症，然而許多病人之視力仍由於視網膜之功能受損而無法達到一定程度之恢復。

並列摘要

Modified en bloc excision is a technique in which all posterior hyaloid is excised except the portions essential for membrane dissection. Then, bimanual dissection techniques allow excision of retained fibrovascular membrane “en bloc” with hyaloid. In a consecutive series of 16 eyes with diabetic traction retinal detachment treated with this technique, visual acuity of 5/200 or better was obtained in 11 (69%) of the cases , and complete macula reattachment was noted in 14 (87%) of 16 eyes. The final visual acuity was improved in 12(75%) cases. While this surgical technique allows a higher rate of anatomic success and less postoperative morbidity, visual results remain limited by irreversible alteration in retinal function.

並列關鍵字

modified en bloc excision technique ； diabetic traction retinal detachment